Healthcare Provider Details

I. General information

NPI: 1669428918
Provider Name (Legal Business Name): DAVID O. CARTAYA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13000 BRUCE B DOWNS BLVD
TAMPA FL
33612-4745
US

IV. Provider business mailing address

1211 TERRA MAR DR
TAMPA FL
33613-1711
US

V. Phone/Fax

Practice location:
  • Phone: 813-972-7514
  • Fax:
Mailing address:
  • Phone: 813-264-1206
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License NumberME 85140
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: